Kalia Phillips, DPT
Individual provider Active NPI Physical Therapist · Southlake, TX
NPI 1699588103 · NPPES record last updated Jan 29, 2025
Key facts
- NPI
- 1699588103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1403070 (TX)
- Practice address
- 180 State St Ste 225
Southlake, TX 76092-7632 - Phone
- (866) 839-6979
- Fax
- (916) 913-5646
- NPI assigned
- Jan 29, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arizona Luna Care Physical Therapy LLC
Texas Luna Care Physical Therapy LLC
Baylor College of Medicine
Practice addresses (Care Compare)
14050 N 83Rd Ave
Suite 290
Peoria, AZ 85381-5650
Phone (866) 525-3175
180 State St
Suite 225
Southlake, TX 76092-7632
Phone (866) 525-3175
7200 Cambridge St
FL 10
Houston, TX 77030-4202
Phone (713) 798-1000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250203003497 | TX | Practitioner - Physical Therapist in Private Practice | 0648700864 | Reassigns benefits to 2 organizations |
| I20260626002591 | AZ | Practitioner - Physical Therapist in Private Practice | 0648700864 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11817 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Luna Care Physical Therapy LLC | Physical Therapist | Current |
Accepting new patients |
| Baylor College of Medicine | Current |
Accepting new patients | |
| Baylor College of Medicine | Current |
Accepting new patients |
Locations
7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2
7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924
180 State St
Ste 225
Southlake, TX 76092
Phone (682) 429-7066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11817 | LA | |
| Physical Therapist | 225100000X | 1403070 | TX | Yes |
Addresses
Primary practice location
180 State St Ste 225
Southlake, TX 76092-7632
Mailing address
180 State St Ste 225
Southlake, TX 76092-7632
Phone (866) 839-6979
NPI Registry JSON
{
"created_epoch": "1738108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1699588103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 STATE ST STE 225",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927632",
"telephone_number": "866-839-6979",
"fax_number": "916-913-5646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 STATE ST STE 225",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927632",
"telephone_number": "866-839-6979",
"fax_number": "916-913-5646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "KALIA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-29",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "11817",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1403070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southlake, TX
- Jasmine Phariss
- Pharmacy Plus Inc
- Philip H Swanson MD PA
- Philip H Swanson, MD PA
- Rijo Thomas Philip
- Liane Phillips
- Sierra Phillips
- Physicians Wellness Associates PLLC
- Genesys Pickens
- Jeremy Pierce
All providers in Southlake, TX · Physical Therapist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.